Medicare’s Bundled Payments for Care Improvement initiative maintained quality of care for vulnerable patients

Date Posted :  April 19, 2019


The Bundled Payments for Care Improvement (BPCI) initiative was intended to incentivize the coordination of services to reduce Medicare payments while improving or maintaining the quality of care. 

Four models were established to test whether linking payments for an episode of care could achieve this.

A team of researchers, including Grecia Marrufo, Jaclyn Marshall, Laura Dummit, Syvart Dennen and Gina Gerding of The Lewin Group, analyzed changes in emergency department visits, unplanned hospital readmissions and all-cause mortality within 90 days of hospital discharge among vulnerable Medicare beneficiaries. 

Beneficiaries included those with one or more of three vulnerable characteristics — dementia, dual eligibility for Medicare and Medicaid, and recent institutional care. 

A total of 105,458 beneficiary episodes between October 2013 and December 2016 were analyzed. The results for 12 types of medical and surgical BPCI episodes were evaluated relative to results in matched comparison groups.

Findings suggest that BPCI model 2, the largest model, did not adversely affect quality of care for beneficiaries with vulnerabilities.

While this conclusion doesn’t discourage the further development of bundled payment models, policy makers should support ongoing research to ensure that vulnerable populations are not adversely affected by these approaches.

The full text article is available on the Health Affairs website.

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